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      The Use of the Personal Digital Assistant (PDA) Among Personnel and Students in Health Care: A Review

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          Abstract

          Background

          Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications.

          Objective

          The aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care.

          Methods

          The literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen’s Model of System Acceptability as a theoretical framework in structuring and presenting the results.

          Results

          From the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen’s Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning.

          Conclusions

          This overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.

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          Most cited references64

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          Usability Engineering

          Written by the author of the best-selling <b>HyperText & HyperMedia,</b> this book is an excellent guide to the methods of usability engineering. The book provides the tools needed to avoid usability surprises and improve product quality. Step-by-step information on which method to use at various stages during the development lifecycle are included, along with detailed information on how to run a usability test and the unique issues relating to international usability.<br><br>* Emphasizes cost-effective methods that developers can implement immediately<br>* Instructs readers about which methods to use when, throughout the development lifecycle, which ultimately helps in cost-benefit analysis. <br>* Shows readers how to avoid the four most frequently listed reasons for delay in software projects.<br>* Includes detailed information on how to run a usability test.<br>* Covers unique issues of international usability.<br>* Features an extensive bibliography allowing readers to find additional information.<br>* Written by an internationally renowned expert in the field and the author of the best-selling HyperText & HyperMedia.
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            Technology induced error and usability: the relationship between usability problems and prescription errors when using a handheld application.

            This paper describes an innovative approach to the evaluation of a handheld prescription writing application. Participants (10 physicians) were asked to perform a series of tasks involving entering prescriptions into the application from a medication list. The study procedure involved the collection of data consisting of transcripts of the subjects who were asked to "think aloud" while interacting with the prescription writing program to enter medications. All user interactions with the device were video and audio recorded. Analysis of the protocols was conducted in two phases: (1) usability problems were identified from coding of the transcripts and video data, (2) actual errors in entering prescription data were also identified. The results indicated that there were a variety of usability problems, with most related to interface design issues. In examining the relationship between usability problems and errors, it was found that certain types of usability problems were closely associated with the occurrence of specific types of errors in prescription of medications. Implications for identifying and predicting technology-induced error are discussed in the context of improving the safety of health care information systems.
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              A review and a framework of handheld computer adoption in healthcare.

              Wide adoption of mobile computing technology can potentially improve information access, enhance workflow, and promote evidence-based practice to make informed and effective decisions at the point of care. Handheld computers or personal digital assistants (PDAs) offer portable and unobtrusive access to clinical data and relevant information at the point of care. This article reviews the literature on issues related to adoption of PDAs in health care and barriers to PDA adoption. Studies showed that PDAs were used widely in health care providers' practice, and the level of use is expected to rise rapidly. Most care providers found PDAs to be functional and useful in areas of documentation, medical reference, and access to patient data. Major barriers to adoption were identified as usability, security concerns, and lack of technical and organizational support. PDAs offer health care practitioners advantages to enhance their clinical practice. However, better designed PDA hardware and software applications, more institutional support, seamless integration of PDA technology with hospital information systems, and satisfactory security measures are necessary to increase acceptance and wide use of PDAs in healthcare.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                Gunther Eysenbach (Centre for Global eHealth Innovation, Toronto, Canada )
                1438-8871
                Oct-Dec 2008
                28 October 2008
                : 10
                : 4
                : e31
                Affiliations
                [3] 3simpleDepartment of Surgery and Perioperation Science simpleUmeå University UmeåSweden
                [2] 2simpleSchool of Human Sciences simpleUniversity of Kalmar KalmarSweden
                [1] 1simpleE-Health Institute simpleUniversity of Kalmar KalmarSweden
                Article
                v10i4e31
                10.2196/jmir.1038
                2629360
                18957381
                12ba98b5-6e29-46c3-a04a-e6174976bf3e
                © Anna M Lindquist, Pauline E Johansson, Göran I Petersson, Britt-Inger Saveman, Gunilla C Nilsson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.10.2008. Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided 1) the original work is properly cited, including full bibliographic details and the original article URL on www.jmir.org, and 2) this statement is included.
                History
                : 12 February 2008
                : 26 March 2008
                : 02 July 2008
                : 23 September 2008
                Categories
                Review

                Medicine
                informatics,medical informatics,computers, handheld,health personnel,students, health occupations,personal digital assistant

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